About the service:

Thornham Grove is a registered care service providing care for up to 34 older people. It is situated in the centre of Ibstock. The accommodation is all on the ground floor. On the day of our inspection visit there were 25 people using the service.

What life is like for people using this service:

People told us they felt safe at the home. They said having staff nearby and their own belongings in their bedroom, made them feels safe. Staff knew how to protect people from harm. The home was well-staffed and people said staff came quickly when they rang their call bells. People had their medicines on time. The home was clean, tidy and fresh.

The staff were skilled and well-trained and provided good quality care and support. People made many positive comments about the food and said their favourite dishes served. Staff made sure people saw their GPs and other healthcare professionals when they needed to. People said they liked the way the with home was decorated. Two people said the call bells were too loud and the managers said they would address this.

The staff treated people with kindness and respect. They remembered people’s birthdays and brought them cards and presents and treated them like their own family members. Relatives could visit the home at any time and were made welcome by staff. People were encouraged and supported to be independent. For example, one person made their own tea in one of the kitchenettes and two people kept pets.

Activities were a big part of life at the home. We saw a bakery session in progress where people were enjoying decorating biscuits. The provider and managers ensured information was provided to people in a way they found accessible. For example, the home used pictorial menus and cards to support people to make choices and take part in activities. People told us that if they had any complaints about the service they would tell the managers or staff.

People told us they were happy living at the home and felt well-cared for. The environment was welcoming with lots for people, relatives and other visitors to look at including information on dignity, the Mental Capacity Act, staff awards, and photographs of activities taking place. The home had a comprehensive audit system in place which led to improvements being made to the service where necessary.

More Information is in the detailed findings below.

Rating at last inspection: Good (report published on 15 June 2016)

At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

We inspected the service on 15 June 2016 and the visit was unannounced. At the last inspection

on 14 November 2014 we asked the provider to take action to make improvements. We asked them to improve their practices in relation to obtaining people’s consent to their care. Following that inspection the provider sent us an action plan detailing what improvements they were going to make. At this inspection we found the provider had made the required improvements and the regulations were being met.

Thornham Grove Care Home is a registered care service providing care for up to 34 older people. At the time of our inspection 33 people were using the service, some of whom had dementia. The service is on one level and split between four areas. Each area has its own lounge and dining areas. All bedrooms are single occupancy. There is also access to a garden area for people to use should they wish to.

The service had a registered manager. It is a requirement that the home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe and staff knew how to protect them from abuse and avoidable harm. People were supported to remain safe as the provider had carried out regular checks on the equipment they used and the premises.

The provider had managed risks that people were vulnerable to. For example, where people were at risk of skin damage this risk had been carefully considered with instructions for staff to follow when supporting people with their skin care needs. The registered manager had analysed accidents and incidents to look at ways to prevent them from reoccurring where possible.

People had mixed views on the staffing levels within the home. We found that staffing levels were adequate. The provider told us that they would look at ways for people to summon assistance when they were alone in the lounges. The provider recruited staff safely.

People’s medicines were being handled safely. For example, staff received regular guidance on how to administer people’s medicines.

People were supported by staff that had received regular training and support. The registered manager had regularly checked the competency of staff to undertake their roles.

Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and people’s consent had been obtained wherever possible for their care and support. Where people may have lacked the capacity to make their own decisions, the provider had followed the requirements of the MCA. For example, mental capacity assessments were in place.

People were satisfied with the food and drink offered to them. Where people required specialist support to maintain their health and well-being this had been requested and was in place.

People had mixed views about the caring approach of staff. We found staff to be supporting people in a kind way. For example, staff spent time with people when they were confused.

People’s dignity and privacy was being respected by staff who knew, for example, how to keep their sensitive information secure and how to involve them in making decisions where possible.

People’s preferences were known by staff. This included their communication needs and things that mattered to them. People were supported to maintain relationships with people that were important to them. Staff made visitors feel welcome.

Where people could, they had been involved in and contributed to the planning and reviewing of their care and support. Where this had not been possible, their relatives or representatives had been included. People had information about independent advocacy services to help them to speak up if they had required this support.

People’s support plans were mai

Thornham Grove Care Home provides care and support for up to 34 older adults, including people with dementia care needs. At the time of our inspection there were 30 people using the service. The home is separated into four units and there is a day centre on the premises which people using the service can access, as well as people from the local community.

At the time of our inspection the registered manager was no longer working at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The provider had appointed a new manager and we saw evidence that they were in the process of submitting an application to become the registered manager.

Our previous inspection of 24 October 2013 found the provider had met all the regulations we inspected.

People we spoke with told us they were satisfied with the care and support provided. They had developed good relationships with their care workers and told us they were treated with kindness and respect and felt safe using the service. Relatives we spoke with confirmed this. Some people told us that staff did not always have enough time to interact with them but confirmed that their care and support needs were met at all times. We discussed this with the manager.

We saw that people were well supported by a staff team that understood their individual needs. We observed that staff were friendly, kind and treated people with respect. The home had a warm and welcoming atmosphere and staff we spoke with had a good understanding of people’s needs and told us they enjoyed their roles.

The provider was not meeting the requirements of the Mental Capacity Act 2005. Where people lacked mental capacity to consent to their care and support the proper procedures to ensure decisions were made in people’s best interests had not been followed.

Staff recruitment procedures were robust and ensured that appropriate checks were carried out before staff started work. Staff received a thorough induction and on-going training to ensure they had up to date knowledge and skills to provide the right support for people. They also received regular supervision and appraisals in line with the provider’s policy. Staff told us they were well supported by the manager and provider.

Staff had received training on how to keep people safe from harm, however, care staff were not always aware of whom to report concerns to outside of the provider organisation. We discussed this with the manager. The manager and senior manager had a good understanding of the local procedures in responding to and reporting allegations of abuse and had ensured that these processes had been followed when required.

The premises and equipment had been well-maintained and were safe for people who lived there. Medication was safely stored and administered by trained staff.

People’s needs were assessed and plans were in place to meet those needs. Staff understood what people’s individual needs were and acted accordingly. Risks to people’s health and well-being were identified and plans were in place to manage those risks. People were supported to access healthcare professionals whenever they needed to and healthcare professionals we spoke with were positive about the quality of care being provided. People’s nutritional and dietary requirements had been assessed and a nutritionally balanced diet was provided.

The manager was clear about the values and aims of the home and was committed to improving the quality of service provided. Staff, relatives and people who lived there told us the manager was approachable and were confident that any concerns or issues they raised would be dealt with appropriately.

There were effective systems in place to assess and monitor the quality of the service. This included gathering the views and opinions of people who used the service and monitoring the quality of service provided.

We found the provider was in breach of one regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which corresponds to one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

People told us they were happy with the support they received. They said staff sought permission before they were helped. People’s care needs were assessed and were provided with support that was tailored to meet their needs including their interests such as hobbies, social events and religious beliefs. People said: “It’s very nice here. The meals are lovely and so are the staff” “and “You just press the buzzer and the staff come running to help.” Relatives were complimentary about the staff , the care provided and cleanliness. A relative said: “We’re going out for lunch today. He seems happy enough here. I’m sure he’ll complain if things are not right.”

People received their medicines on time and were confident that staff were trained to administer medicines. One person said: “They [staff] bring my tablets to me; I have one tablet in the morning and two at night.”

People lived in an environment that was clean, safe and adequately maintained. Staff were trained to ensure people were safe. There were systems in place to reduce the risk and spread of infection. Regular checks were carried out on the premises to make sure it was safe and equipment used were adequately maintained.

People were supported by staff that had been screened to ensure they were suitable to work with vulnerable people and trained for their job.

The Care Quality Commission found the registered manager was qualified, experienced and fit to manage Thornham Grove Care Home on a day to day basis.

People told us they were well cared for. People said they were treated with respect and involved to make sure their care and supports needs were provided in a manner that suited them. One person said “I feel safe and support well by staff.”

People had a range of assessments and care plans in place that detailed the care and treatment they needed. Records showed people’s health and care needs were monitored and reviewed regularly. Medicines prescribed and were administered safely. There were arrangements in place to support people safely and to deal with foreseeable emergencies.

People received support from trained staff and staffing levels that ensured their care and support needs were met promptly. One person said “The staff are very good and it’s never a problem when you ask for help.”

People using the service and their relatives had opportunities to comments and give their views about the quality of services experienced.

The provider had an effective quality assurance system, which monitored the day to day running of the service. These included audits and checks on the environment, and the management and delivery of care, staff and health and safety.

One person told us about their experience of living at Thornham Grove, they said ‘you can’t fault it and you get good food’.

One person said that people living at Thornham Grove were constantly calling out for staff attention.

People told us they felt safe living at Thornham Grove and would speak to the manager if they had any concerns.

People spoken with told us their choices were respected and they were enabled to maintain as much independence as possible.

One person told us ‘the staff are very good, they look after the residents’.

People told us that staff contacted their GP when this was needed.